“Best Cities for Successful Aging” Report
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2014 Best Cities for Successful Aging 2014 Anusuya Chatterjee and Jaque King Introduction by Paul Irving MILKE N Ins TITUTE Our Best Cities for Successful Aging initiative is about more than just rankings. It’s about change. Changing policies and practices to promote healthy, productive, and purposeful aging requires transformative work and collaboration with a broad range of like-minded individuals and institutions. Many have helped. I’ll recognize just a few of them here. First, I want to thank my research colleagues, Anusuya Chatterjee and Jaque King, for their project design, research, analysis, and authorship of our “Best Cities for Successful Aging” report. Their work to improve aging lives is important and impactful. Thanks to Sindhu Kubendran for her valuable research assistance. Thanks to Zach Gassoumis, Caroline Cicero, and Mollie Grossman of the University of Southern California Davis School of Gerontology for their research support as well. My appreciation to Ross DeVol and Perry Wong, also of our research group, for their support of our Best Cities for Successful Aging work from our first conversations about the initiative. Thanks to Conrad Kiechel, Jeff Monford, and Melody Yuan for their communication support, and the members of our executive staff, including Shantika Maharaj and Fran Campione, who provided valuable assistance in this effort. My appreciation to Rita Beamish for her skillful and insightful writing assistance, to Edward Silver for his sure editorial hand, and to Jane Lee for her creative design work. Our Best Cities for Successful Aging (http:// successfulaging.milkeninstitute.org/) and Best Cities for Successful Aging Mayor’s Pledge (http://successfulaging.milkeninstitute.org/mayors-pledge/) websites depend on the ideas and TABLE OF CONTENTS expertise of our information technology and creative services groups. And many others at the Institute help us advance this work in their own ways. 2 Introduction This year, we initiated our Mayor’s Pledge project. We’re gratified that so many forward-thinking 8 Top 20 Large Metros mayors across the country have taken the Pledge. Thanks to Nichole Wright for her outreach efforts to mayors and city leaders, and to Kathleen Helppie-Shipley, Monique Midose, and Taylor 20 Top 20 Small Metros Booth for their terrific work raising awareness and support for the Pledge. 32 Programs with Purpose Special appreciation to the extraordinary leaders who serve on our Best Cities for Successful 38 Mayor’s Pledge Aging Advisory Committee (listed on Page 59). Their advice is invaluable, and their good work on behalf of older adults and others across the age spectrum inspires hope for a brighter future. 42 Methodology I want to acknowledge and express my deep gratitude and the appreciation of all involved to our 52 Rankings for All Metros Best Cities for Successful Aging supporters, the Robert Wood Johnson Foundation, AARP, and the Transamerica Institute for sharing their resources, insights, and ideas. We could not do this 59 Best Cities for Successful work without their assistance. Finally, let me recognize and thank the John Templeton Foundation Aging Advisory Committee for our continuing collaboration to elevate and enable beneficial purpose for older adults. 61 About the Authors Paul Irving Santa Monica, California ©2014 Milken Institute. This work is made available under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License, available at creativecommons.org/licenses/by-nc-nd/3.0/ ABOUT THE MILKEN INSTITUTE A nonprofit, nonpartisan think tank, the Milken Institute works to improve lives around the world by advancing innovative economic and policy solutions that create jobs, widen access to capital, and enhance health. We produce rigorous, independent research—and maximize its impact by convening global leaders from the worlds of business, policy, health, education, media, and philanthropy. By fostering collaboration between the public and private sectors, we transform great ideas into action. Introduction Two important, unassailable facts underpin our 2014 “Best Cities for Successful Aging”™ report: Our nation is aging at an unprecedented rate, in a titanic shift that is creating the largest older population in history; and these mature adults live predominantly in urban settings. A product of lower birth rates and increasing longevity, this phenomenon is changing the landscape of the United States and the world. 3 I NT R O D As a growing population of older adults emerges, timeworn The Milken Institute is proud to present our 2014 “Best Cities U C T notions of aging no longer fit. Older adults are staying in for Successful Aging,” which updates and expands on our I ON the workforce longer and anticipating more meaningful “golden groundbreaking 2012 report. The report measures, compares, years.” New attitudes about work, health, housing, education, and ranks 352 U.S. metropolitan areas based on how well they transportation, and other needs are evident. Millions of aging enable older people to fulfill their potential, in their own lives as adults are upending convention, seeking to remain active and well as in their contributions to society and to others across the contributing members of their communities. A revolution in the age spectrum. “culture of aging” is underway. Cities are on the frontlines of the challenges and opportunities MI EASUR NG SUCCESS that accompany this revolution. How U.S. cities and their We know that physical and social surroundings can support or leaders deal with these realities will affect not just the course inhibit health, engagement, productivity, and purpose as people age. of millions of individual lives, but more broadly our ability to build “Best Cities” identifies age-friendly living environments that foster a better America. well-being, which in turn can mitigate age-associated decline. With this second edition of the Milken Institute’s “Best Cities for Successful Aging” report, we examine how metropolitan areas are stepping up to the challenge, and we rate and rank their capacity to enable people to age independently and productively, with security and good health. MI I LLIONS of AG NG ADULTS ARE UPenDING conVentION, seeKING TO NOT JUST ANOTHER TOP 10 With nearly 80 million American baby boomers facing the REMAIN actIVE AND contRIBUTING fulfillments and stresses of aging, there’s no shortage of lists heralding “best” locations for older adults. There’s a veritable MEMBERS of THEIR commUNITIes. universe of eye-catching honor rolls often based on some combination of factors such as mild weather and affordable living. However, they tend to include only subsets of the many factors that actually define such locations. Our methodology uses publicly available data on health care, wellness, living arrangements, transportation, financial There is little question about where we want to age. The characteristics, employment and educational opportunities, vast majority of older people—up to 90 percent, according to community engagement, and overall livability. The aim is to AARP’s research—want to age in place and at home. The crucial highlight and encourage best practices that enhance the lives of question is how we want to spend those later years. To age in older people and the cities in which they live, and by extension place successfully, older adults must enjoy environments that improve the nation as a whole. support health and productivity and the ability to live purposeful, contributing lives. With other challenges dominating policymaking The report differs from other “best” rankings that tend to at the national and state levels, urban leaders may offer America’s be based on opinion polls or narrow aspects of aging. Our best opportunity for positive change to facilitate vitality and data-driven, detailed approach provides a deeper level of engagement as we age. analysis. Developed by our research staff with input from our “Best Cities for Successful Aging” Advisory Committee, the • Financial security, including opportunities for work report’s rankings are based on a weighted, multidimensional and entrepreneurship. We examined each area’s tax burden, methodology that examines a broad range of quality-of-life small-business growth, poverty levels, and employment rates for factors for older Americans. those 65-plus, and the data on reverse mortgages. We reviewed employment opportunities and factors tied to encore careers. To produce these evaluations, we looked at broad criteria that we believe define successful aging in the 21st century. Such criteria • Living options for mature residents. We compiled statistics are commonly cited by academics and institutions that promote on the costs of homeownership and rental housing, nursing age-friendly communities: homes and quality nursing care, assisted living facilities, and home health-care providers. • Safe, affordable, and convenient environments. We compiled statistics on cost of living, employment growth, • Mobility and access to convenient transportation systems. jobless rates, income distribution, crime rates, alcoholism, We studied commute times, fares, the use of and investment in and weather. transit for the public and for older residents specifically, and the number of grocery stores and other key retailers. • Health and happiness. We looked at a range of factors, including the number of health professionals, hospital beds, • Beneficial engagement with families and communities, long-term hospitals, and facilities with geriatric, Alzheimer’s, and physical,